In an effort to identify clinical findings associated with deterioration and mortality after PE, the authors prospectively monitored 298 pts admitted through the ED with documented PE. 34% of pts experienced clinical deterioration, which was associated with hypotension, hypoxia, residual DVT, CAD, and right heart strain on echocardiogram. In contra
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Critical Care
August 6, 2014
This prospective trial from 14 ICUs in northern Europe evaluated the potential benefit of adding immune-modulating nutrients (IMHP) to standard enteral nutrition in reducing infectious complications in ventilated patients. The addition of IMHP did not alter the incidence of infectious complications, but was associated with much worse 6 month surviva
August 2, 2014
2014 consensus guidelines on the perioperative evaluation and management of patients undergoing NONCARDIAC surgery.
June 26, 2014
The cause of ischemic stroke remains elusive in up to 20-40% of cases. In patients with cryptogenic stroke, 8.9% of patients with long term monitoring using an insertable cardiac monitor were found to an episode of atrial fibrillation, which may have implications in therapy.
June 16, 2014
Using data from the Australian Cardiac Surgical Database, the authors provide further information regarding acute kidney damage after cardiac surgery. This study has added to the evidence that preoperative impairment, IABP use, red cell transfusion and infective endocarditis are predictive factors.
June 16, 2014
The rate of cerebral embolism in patients with acute infective endocarditis (AIE) was about one quarter on CT scanning, with about one third having silent emboli. This had an adverse impact on survival. Haemorrhagic transformation was low. The authors indicate CT scanning should be routine for all patients with AIE.
May 23, 2014
Stepped wedged cluster randomized control trial from the World Health Organization comparing outcomes in those who received a Checklist. Implementation of the WHO Surgical Safey Checklist decreased morbidty and hospital length of stay.
May 23, 2014
In this extensive review, the authors focus on extracorproreal membrane oxygenation (ECMO), both for cardiac and respiratory failure. They describe the explosive increase in ECMO use, the expanding indications, and the need for more evidence-based use.
May 6, 2014
The authors reviewed transfusion practices after cardiac surgery in Australia and New Zealand using a database of nearly 43,000 patients. Transfusion rates for >=1 unit varied 3-fold (22% to 67%), for >=5 units varied 5-fold, >=1 platelet pack varied 3-fold, >=1 FFP varied 4 fold, and >=1 cryoprecipitate varied 20-fold. The differenc
May 3, 2014
For those of you anticipating the need to perform an emergency cricothyroidotomy outside of a medical setting, this article will guide you to the best pen to use for this purpose. [Spoiler alert: Baron retractable ballpoint and BIC soft feel jumbo]